In patients with chronic pancreatitis, the viscosity and trypsin activity of the pure pancreatic juice obtained endoscopically are significantly higher than in healthy subjects. These two parameters may thus represent a simple method for the diagnosis of chronic pancreatitis.
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Gastroenterol Clin North Am
March 2025
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware Street SE, MMC 36, Minneapolis, MN 55455, USA. Electronic address:
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India.
Pancreatic duct (PD) strictures, leaks, and disconnected ducts are important morphologic consequences of inflammatory disease of the pancreas, resulting in abdominal pain, pancreatic ascites, pancreatic pleural effusion, and external pancreatic fistula. Traditionally, these PD complications were treated surgically, but a better understanding of their pathophysiology, along with advancement in endoscopic interventions, has transformed the therapy from morbid surgical interventions to minimally invasive, safe, and effective endoscopic treatment. This review discusses the current diagnostic and management strategies for PD strictures, leaks, and disconnected pancreatic ducts.
View Article and Find Full Text PDFGastroenterol Clin North Am
March 2025
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Electronic address:
Autoimmune pancreatitis (AIP) is a steroid-responsive fibroinflammatory disorder with 2 clinically distinct subtypes known as type 1 autoimmune and type 2 autoimmune pancreatitis. Type 1 AIP is considered the pancreatic manifestation of immunoglobulin G4-related disease, a systemic disease often presenting with other organ involvement. Advances in understanding the unique clinical presentation, imaging findings, histopathology, and clinical course of this relatively uncommon disease have led to international consensus regarding diagnosis and treatment.
View Article and Find Full Text PDFGastroenterol Clin North Am
March 2025
Department of Pediatrics, University of Minnesota, MMC 391, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA. Electronic address:
Diabetes (DM) can occur as a complication of acute, acute recurrent, or chronic pancreatitis, affecting more than 30% of adults with chronic pancreatitis. Data on the pathophysiology and management are limited, especially in pediatric population. Proposed mechanisms include insulin deficiency, insulin resistance, decreased pancreatic polypeptide, and possible beta-cell autoimmunity (in a small subset).
View Article and Find Full Text PDFGastroenterol Clin North Am
March 2025
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA. Electronic address:
This article provides an up-to-date review of the management of chronic pancreatitis, highlighting advancements in medical therapy, nutritional support, endoscopic and surgical approaches, and emerging treatments. Nutritional management accentuates addressing malabsorption and nutrient deficiencies. Advances in endoscopy and parenchyma-sparing surgical techniques have opened new avenues for improved patient outcomes, with total pancreatectomy and islet autotransplantation offering the only definitive solution for selected patients.
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